Explore detailed information about a range of joint problems and treatments, including medications, surgery, physiotherapy and rehabilitation. Reading this will help you understand more about your own condition. There is also a glossary with explanations of many medical terms used in orthopaedics. You can find out even more by following the links page to other related websites, journals or professional medical associations.
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Author: DAVID P JOHNSON MB ChB FRCS FRCS. MD
Consultant Orthopaedic Surgeon
Glucosamine and Chondroitin
Glucosamine and chondroitin have been shown to have some beneficial effects on osteoarthritic joints, and so may be worth trying if you have this kind of joint problem.You can try this type of product by clicking on the image for this liquid form of glucosamine, said to have a much faster and more complete uptake than capsules.
Osteoarthritis (OA) is the most widespread type of arthritis, a degenerative condition of the joints. Acute inflammation is uncommon in OA and it is mostly a “wear-and-tear” disease involving degeneration of joint cartilage and the formation of bony spurs in various joints.
Joint trauma, repetitive joint stresses in jobs, and obesity are risk factors. OA is very common over 60 years of age, but not always troublesome. You will have seen advertising and promotion of glucosamine and chondroitin as a treatment for OA.
What are these substances?
Glucosamine, an amino sugar, is a natural substance made by your body, an essential building block of joint cartilage, ligaments, bones and blood vessels, and is thought to promote the formation and repair of cartilage.
Chondroitin, a carbohydrate, is a natural cartilage component linked to levels of water retention and elasticity and to the inhibition of enzymes that break down cartilage. Both compounds are manufactured by the body.
You can buy both these dietary supplements as tablets from your local health food shop or chemist and they are often taken together.
Glucosamine may stimulate the production of cartilage-building proteins and chondroitin may inhibit the production of cartilage-destroying enzymes and fight inflammation. The shells of shellfish are the source of glucosamine, while chondroitin supplements are extracted from the cartilage of cows.
Studies on people have shown that both may relieve arthritic pain and stiffness with fewer side effects than conventional arthritis drugs. However, there is no evidence to suggest that they are as effective as conventional drug therapies. The manufacture and distribution of these drugs is not restricted or regulated in the same exacting way conventional drugs are. The nature of the active ingredient and effectiveness or indeed concentration of the active compound in each of the available products varies widely.
We don’t really know as there isn’t any convincing evidence that glucosamine or chondroitin help to ease the symptoms of osteoarthritis. There is some weak evidence that glucosamine, or a combination of glucosamine and chondroitin, might be helpful and no evidence that taking chondroitin on its own is helpful. Glucosamine may help by reducing pain and stiffness rather like a non steroidal anti-inflammatory drug (NSAID). Some trials have shown that glucosamine, or glucosamine plus chondroitin, can help to control the symptoms of osteoarthritis. However, these trials have faults in them which make the results unreliable. So it is difficult to be sure whether these treatments work or not.
Glucosamine and chondroitin products are marketed as “dietary supplements”. Glucosamine is available in many forms, including glucosamine sulfate, glucosamine hydrochloride (HCl), and N-acetylglucosamine (NAG), and have various other contents. However, there appears to be no conclusive evidence that one form is better than another.
No serious side effects from either glucosamine or chondroitin have been found in the trials to date.
Go to Best Treatments and Clinical Evidence and put “glucosamine” or “chondroitin” into the search boxes. Both these useful sites give reference lists to the medical evidence.
ConsumerLab is a very useful site, with analysis of all the evidence and also of the products. Some products don’t have any of the substance in them that they claim to have!
If you’d like to think about the issues and make an informed decision, the US Food and Drug Administration Centre for Food Safety and Applied Nutrition has issued a document Tips for the Savvy Supplement User: Making Informed Decisions And Evaluating Information which may be of interest.
Arthritis Care www.arthritiscare.org.uk
Complementary Medicine Association www.the-cma.org.uk
National Ankylosing Spondylitis Society www.nass.co.uk
Ankylosing Spondylitis is one of the commonest arthritic diseases, especially amongst young men. Although not usually severely disabling, it can have a big effect on a person’s life.
Arthritis Research Campaign www.arc.org.uk
The ARC is the fourth largest medical charity in the UK and had an annual income of £26m in 2001-2. It funds research into all the different kinds of arthritis and provides information for professionals and the public.
Arthritis Researchalot.com. Resource site for everything to do with arthritis. Full of newletters, articles, links and other resources – ALL FREE – in one easy to navigate site to save time and money.
Arthritis Resources. Comprehensive information. A comprehensive site devoted to arthritis and degenerative joint disease. www.arthritisedu.com
Disclaimer: The views expressed in this article are not necessarily those of Orthopaedic Opinion Online or the author. The information is provided for general background reading only and should not be relied upon for treatment. Advice should always be taken from a registered medical practitioner for individual circumstances and for treatment of any patient in any circumstances. No liability is accepted by Orthopaedic Opinion Online, or the author in respect to the information provided in respect of the content or omission or for any reason or as a result of treatment in individual circumstances. This information is not for use in the USA.